Provider Demographics
NPI:1841227352
Name:KOLLAR, JOHN C (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:KOLLAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449B MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5941
Mailing Address - Country:US
Mailing Address - Phone:201-712-7900
Mailing Address - Fax:201-712-7902
Practice Address - Street 1:449B MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5941
Practice Address - Country:US
Practice Address - Phone:201-712-7900
Practice Address - Fax:201-712-7902
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB52216208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5499208Medicaid
NJ702435RSKMedicare PIN
702435B61Medicare PIN
NJ5499208Medicaid